Looking for answers and wondering what are the first signs of Perimenopause Symptoms? Read on to learn the top 5 most common signs and symptoms of perimenopause, why they happen, how to recognize perimenopause, and more!

Top 5 First Signs of Perimenopause Symptoms

Perimenopause, the transitional phase leading up to menopause, is a natural part of a woman’s life. It is during this time that the body undergoes some wild hormonal changes, and it’s important for women to be aware of the early symptoms that may arise.

Early perimenopause symptoms can vary greatly among women, but some common signs include irregular periods, hot flashes, mood swings, changes in sexual function, and changes in energy levels and/or ability to focus. These are just a few indications that your body is entering the perimenopause stage.

This blog is all bout recognizing the first signs of perimenopause symptoms. 

Understanding the signs and symptoms of perimenopause is crucial for midlife women, women in their early 40s, or even women in their late 30s. By recognizing these early indicators, you can gain a better understanding of what your body is going through and take steps to manage and support your perimenopause roller coaster ride effectively.

In this article, we will explore the different stages of perimenopause, delve into the physical and emotional changes that may occur, discuss the impact on fertility and sexual health, consider the importance of bone density and cardiovascular health, and provide insights on seeking medical advice during this phase of life. Let’s navigate the perimenopause transition together!

Understanding Perimenopause: The Menopausal Transition

The perimenopause stage is a natural and inevitable part of a woman’s life, representing the transition leading up to menopause. During this time, the body undergoes hormonal changes that can have a significant impact on a woman’s overall well-being.

Defining Perimenopause and Its Onset

Perimenopause is the period when a woman’s body starts preparing for menopause. It typically begins in a woman’s 40s but can occur as early as the mid to late-30s in some cases. During this time, hormonal fluctuations occur, leading to various physical and emotional changes. These changes can vary from woman to woman, making it essential for individuals to be aware of the signs and symptoms associated with perimenopause.

Estrogen Fluctuations: The Role They Play

Estrogen, a vital hormone in a woman’s body, plays a crucial role in the perimenopause transition. As a woman’s body prepares for menopause, the levels of estrogen fluctuate, leading to a range of symptoms and changes in the menstrual cycle.

These estrogen fluctuations can result in irregular periods, mood swings, hot flashes, and other common perimenopause symptoms. Understanding the impact of estrogen fluctuations is important in knowing what to expect from early, mid, and late perimenopause.

Progesterone Decline: It’s Slow and Steady

During perimenopause, there is also a shift in progesterone levels.  This hormone that cushions and lines the uterus while waiting for a fertilized egg in the second half of a woman’s cycle now steadily declines.  It may still fluctuate like estrogen but it tends to get gradually lower and lower.  This gradual decline in progesterone can cause night sweats, brain fog, mid-cycle spotting, and contribute to some of the above symptoms like mood swings, insomnia, and irregular periods. 

The First Signs of Perimenopause Symptoms

Perimenopause, the transitional phase leading up to menopause, is marked by various symptoms that can help women recognize the onset of this stage in their lives. When perimenopause begins, women may experience the following early signs:

1. Irregular periods: The menstrual cycle may become unpredictable, with periods occurring closer together or further apart than usual.
2. Changes in menstrual flow: A woman may notice differences in the duration or intensity of her menstrual bleeding.
3. Hot flashes or Night Sweats: These sudden, intense feelings of heat accompanied by flushing and sweating can be a key indicator of perimenopause.  Night Sweats tend to occur in the earlier stages of perimenopause due to the progesterone decline, while hot flashes occur more often in the late stages of perimenopause.
4. Mood swings: Hormonal fluctuations during perimenopause can lead to emotional changes, including irritability, anxiety, and depression.
5. Sleep disturbances: Many women experience trouble sleeping during perimenopause, such as insomnia or waking up frequently throughout the night.

It is important to note that the severity, timing, and duration of these symptoms can vary among women.  Some women, for example, may have hot flashes as an early stages of perimenopause and never have night sweats.  Or vice versa.  There is not one roadmap for all women.

Recognizing these early signs can empower women to seek appropriate support and implement effective management strategies to navigate through the perimenopause transition with greater ease.

Finding a healthcare provider that is trained and comfortable with perimenopause is key in getting good care during this sometimes crazy period in your life- yes that pun was intended!

Irregular Periods and Their Variations as Perimenopause Indicators

During perimenopause, as noted above, women may experience irregular periods as their menstrual cycles undergo significant changes.   This can be different for every woman.

Some women may have a longer amount of time between periods while some may have them more frequently than before.   Another common sign could be having heavier or lighter periods than you used to.

Understanding and monitoring irregular periods, including changes in menstrual cycle length and flow patterns, can help women navigate this transitional phase with greater awareness and proactive management.

Irregular Period Indicators	Meaning
Lengthening of the menstrual cycle	Progesterone levels decline, leading to a delayed period or changing luteal cycle.
Shortening of menstrual cycle	Estrogen levels fluctuate, and progesterone levels decline leading to early ovulation and a shorter cycle.
Lighter or heavier menstrual flow	Estrogen and progesterone imbalances affect the shedding of the uterine lining, resulting in lighter or heavier flows.
Skipped periods (amenorrhea)	Fluctuating hormone levels including FSH and LH disrupt the regularity of ovulation, causing missed periods.

Physical and Emotional Changes During Perimenopause

Perimenopause is a transformative phase that brings about various physical and emotional changes in women. As hormone levels fluctuate, the body adapts to these shifts, resulting in a range of experiences that can vary from woman to woman.

The Impact of Estrogen on Mood Swings

One of the key hormonal changes during perimenopause is the fluctuation in estrogen levels. Estrogen is closely linked to mood regulation, and when its levels fluctuate, it can lead to mood swings, irritability, and even an increased risk of depression.

Women may find themselves experiencing sudden shifts in mood, feeling tearful or moody without apparent cause. These emotional changes can be frustrating and overwhelming, but understanding how common this is and where it may be coming from can be a great relief for many women.

Hot Flashes and Night Sweats: What to Expect

Hot flashes and night sweats are common symptoms experienced during perimenopause.  These episodes are sudden feelings of intense heat, often accompanied by flushing and sweating, and can occur at any time of the day or night, disrupting sleep and daily activities.

Night sweats are thought to be triggered by declining progesterone levels.  While the exact cause is not fully understood, it is also believed that the hypothalamus, the part of the brain responsible for regulating body temperature, becomes more sensitive to slight changes in estrogen and progesterone levels.

Managing hot flashes and night sweats can be challenging, but there are strategies that can help. From dressing in layers to using cooling products or practicing relaxation techniques, or even trying natural supplement support, finding what works best for each individual is essential. Additionally, discussing symptoms with a healthcare provider (one who understands what you’re going through) can provide further guidance and potential treatment options.

Though emotional changes can come directly from the hormonal roller coaster that perimenopause can be, they can also be triggered by the physical changes too.

Common Symptoms	Physical Changes	Emotional Changes
Hot Flashes	Intense heat, flushing, and sweating	Irritability, mood swings
Night Sweats	Excessive sweating during sleep	Anxiety, mood disturbances
Irregular Periods	Variations in menstrual cycle length and flow	Increased emotional sensitivity
Changes in Sexual Function	Dryness, decreased libido	Diminished sexual desire or satisfaction
Changes in Bone Density	Loss of bone mass, increased risk of osteoporosis	Anxiety, worry about aging

Perimenopause and Fertility: What You Should Know

During perimenopause, women can also experience a decline in fertility due to irregular ovulation. While it is still possible to get pregnant during this stage, the likelihood decreases.

I often get asked this question by patients- so can I still get pregnant if I’m in perimenopause? And the answer is absolutely yes, so if this is something you don’t want then it’s best to take appropriate precautions.

Continued Need for Contraception

Irregular ovulation means that it is still possible for women to conceive, even if their menstrual cycles are no longer regular. Contraceptive methods such as hormonal birth control, intrauterine devices (IUDs), or barrier methods can help prevent unintended pregnancies during this transitional phase.

Key Points:	Perimenopause and Fertility
1	Fertility declines during perimenopause due to irregular ovulation.
2	Even with irregular periods, pregnancy is still possible.
3	Continue using contraception until reaching menopause (12 consecutive months without a period).

Sexual Health and Perimenopause

Perimenopause can have a significant impact on a woman’s sexual health. During perimenopause, many women experience changes in sexual desire and arousal.

These changes can be attributed to fluctuating hormone levels, and both estrogen and progesterone levels can be a cause. Testosterone may also start to decline in perimenopause, particularly if significant muscle mass is lost.

It’s important for women to address these changes and seek support and solutions to maintain a fulfilling and satisfying sex life.

Addressing Changes in Sexual Desire

One of the common symptoms of perimenopause, as noted above, is a change in sexual desire. Some women may experience a decrease in libido, while others may have an increase in sexual desire. These changes can be attributed to hormonal fluctuations and other factors such as fatigue, mood swings, and stress. Open communication with your partner and healthcare provider is crucial in addressing these changes and exploring strategies to enhance sexual desire and satisfaction.

Challenges of Vaginal Dryness and Discomfort

Vaginal dryness is another common issue that women may face during perimenopause. Decreasing estrogen levels can lead to a decrease in natural lubrication, resulting in discomfort during intercourse. This can cause pain, irritation, and even a loss of sexual interest.

Fortunately, there are various treatment options available to help with vaginal dryness, including vaginal moisturizers, lubricants, and hormone therapy. Talking with your healthcare provider can help you find the best way for you to address this challenge and restore comfort and pleasure during sexual activity.

I’ll link some of my favorite aids for vaginal dryness in the table below.  If you have tried these and feel that you need to proceed to hormone therapy I find that progesterone can help, or even a topical low-dose vaginal estriol cream can be helpful in the later stages of perimenopause.

Common Sexual Health Challenges During Perimenopause	Possible Solutions
Changes in sexual desire	Open communication with partner and healthcare provider, exploring strategies to enhance sexual desire and satisfaction
Vaginal dryness	Vaginal moisturizers, lubricants, hormone therapy

Bone Density and Cardiovascular Health in Perimenopause

In addition to the various symptoms experienced during perimenopause, such as irregular periods and mood swings, this transitional phase also affects bone density and cardiovascular health.

Estrogen’s Role in Bone Density Preservation

Estrogen plays a vital role in maintaining optimal bone density. During perimenopause, estrogen levels begin to decline, leading to a gradual decrease in bone mass. This decline in estrogen can increase the risk of osteoporosis, a condition characterized by weak and brittle bones.

Women experiencing perimenopause should pay close attention to their bone health and take proactive measures to preserve their bone density.  Estrogen levels don’t decline until the later stages of perimenopause, though they do fluctuate greatly in the first stages.  Being prepared in the early stages by starting or increasing your strength training and/or other weight bearing exercises like yoga, pilates, or even walking, can make quite a difference in your bone density later on.

Cholesterol Levels and Heart Disease Risk

In addition to bone health, perimenopause is also associated with changes in cholesterol levels, which can impact heart health. Estrogen helps maintain healthy cholesterol levels by decreasing the levels of LDL (low-density lipoprotein) and increasing the levels of HDL (high-density lipoprotein).

However, as estrogen levels decline during late perimenopause, the balance between LDL and HDL cholesterol may shift, increasing the risk of heart disease. Monitoring cholesterol levels in early perimenopause is important so you can go into late perimenopause prepared for what may come.

Perimenopause	Bone Density	Cardiovascular Health
Estrogen decline	Increased risk of osteoporosis	Changes in cholesterol levels
Regular bone health monitoring	Lifestyle changes and treatments	Heart-healthy habits

Seeking Medical Advice: When to Contact Your Healthcare Provider

It is important for women to prioritize their well-being and self care during the perimenopause stage. If you are experiencing severe or disruptive symptoms, don’t suffer in silence.

A good healthcare practitioner can provide guidance, support, and appropriate treatment options to help you manage your perimenopause symptoms so that they don’t take over your life!

Knowing when to contact your healthcare provider is super helpful so you don’t feel alone and confused.

Here are some scenarios in which reaching out to them is recommended:

1. If you are experiencing severe or persistent perimenopause symptoms, such as intense hot flashes, excessive mood swings, or disrupted sleep patterns.
2. If you have concerns about changes in your menstrual cycle, such as heavy bleeding, prolonged periods, or spotting between periods.
3. If you have a family history of certain conditions, such as osteoporosis or heart disease, and want to discuss your risk factors and preventative measures.
4. If you are considering hormone replacement therapy (HRT) or other treatment options (these could include natural therapies) for managing your perimenopause symptoms.
5. If you have questions about contraception or family planning during perimenopause.

Remember, seeking medical advice and engaging in open communication with your healthcare provider is an important part of your perimenopause journey. They are there to support you, provide professional guidance, and help ensure your overall well-being during this transition.

Understanding Hormonal Changes during as the First Signs of Perimenopause Symptoms: Estrogen and Progesterone’s Role

Estrogen Dominance and Its Effects

Estrogen dominance, which occurs when estrogen levels are relatively high compared to progesterone, can lead to various symptoms and imbalances.  The first stage of perimenopause is usually when estrogen dominance affects women.

Estrogen dominance during perimenopause can cause:

• Increased breast tenderness
• Irregular periods
• Water retention and bloating
• Decreased sex drive
• Increased risk of weight gain
• Mood swings and irritability

Managing estrogen dominance is an essential aspect of perimenopause symptom management. Lifestyle changes, such as stress reduction, regular exercise, and a balanced diet, can help regulate estrogen levels and alleviate symptoms of estrogen dominance.  Check out this blog to learn more!

The Balance Between Changing Estrogen and Low Progesterone

During perimenopause, the balance between estrogen and progesterone is disrupted, often resulting in low progesterone levels. Low progesterone levels, combined with high estrogen levels, can contribute to symptoms such as:

• Irregular periods
• Heavy or prolonged menstrual bleeding
• Mood changes and anxiety
• Sleep disturbances

We talk about this at length in this blog!

Identifying Early Signs of Perimenopause

Ok, we have talked about much mor than the top 5 first signs of perimenopause symptoms so let’s sum this up:

Early Signs of Perimenopause

Signs	Description
Spotting	Light vaginal bleeding occurring outside of regular menstruation
Menstrual Irregularity	Changes in the length and regularity of menstrual cycles
Night Sweats (or mild hot flashes)	Sudden waves of sweating or heat, often at night; sometimes with rapid heartbeat
Mood Swings	Emotional fluctuations characterized by sudden mood changes, anxiety, or depression
Sleep Disturbances	Difficulty falling asleep or staying asleep throughout the night
Changes in Sexual Function	Alterations in sexual desire, arousal, or enjoyment

Recognizing the early signs of perimenopause can empower women to navigate this phase of life with knowledge and confidence. It is important to remember that every woman’s experience is unique, and seeking guidance from healthcare providers is essential for individualized support and care.

Conclusion

Embracing the Perimenopause Transition

The perimenopause transition is a natural and inevitable phase in a woman’s life. It marks the beginning of a new chapter, bringing with it a range of changes and challenges. Instead of viewing perimenopause as a time of decline, it is an opportunity to embrace the changes and spend more time on understanding yourself, as well as taking a deeper dive into your mental and physical health.

Take this time to nourish your body with supportive foods, start or upgrade your exercise program, and practice mindfulness in ways you may not have before (think meditation, mantras, deep breathing, yoga, or nature walks).

With the right support, resources, and self-care, women can confidently embrace the perimenopause transition and embark on a healthy and thriving journey towards menopause and beyond!

You may also enjoy reading or watching:

Everything you need to Know about Perimenopause and Shorter Period Cycles!

7 Sneaky Signs of Estrogen Dominance in Perimenopause

Best Natural Supplements For Perimenopause